Timothy Ray Brown (second from left) with Dr. Gero Hütter (far left), the German hematologist who did the transplant that cured him; and Fred Hutch researchers Drs. Keith Jerome and Hans-Peter Kiem during a visit to the Hutch campus in 2015.

Photo by Robert Hood / Fred Hutch News Services

The Story Behind an HIV Cure

Timothy Ray Brown, also known as the “Berlin patient," is the first person ever cured of HIV. He was diagnosed with the disease in 1995. Then, after using antiretroviral drugs to stave off HIV for more than a decade, Brown received another staggering diagnosis: acute myeloid leukemia.
His doctors decided to use radiation and chemotherapy to wipe out his immune system, then rebuild it with donated stem cells. But they added a game-changing twist to this standard treatment: They deliberately picked a donor who was immune to HIV. About 1 percent of Caucasians carry a gene mutation that triggers this immunity. In scientific terms, this means their cells don’t have CCR5, a protein that opens the door for HIV to enter blood cells. For Brown, it meant a new chance at life. Brown received two stem cell transplants that knocked out his cancer and transferred the genetic variation to his immune system.

“It’s an incredible feeling – like a miracle,” he said. “I had two lethal diseases and was able to get rid of both of them.”

In pursuit of a cure

Brown, who was born in Seattle, has visited Fred Hutch several times to meet with Hutch scientists conducting cure research. In 2011, a research collaboration led by Drs. Keith Jerome and Hans-Peter Kiem received a $20 million federal grant to develop cell and gene therapies for making an HIV-infected person's own immune cells resistant to HIV infection. As that research continues, the group received a second, $23.5 million grant to tackle three new approaches that build on this work: exploring CAR T-cell therapy, a type of immunotherapy, against HIV; using gene therapy to induce production of a synthetic “super antibody” to target HIV; and adding a therapeutic vaccine to boost the proliferation and function of genetically modified HIV-resistant cells. This research builds on the remarkable success of Timothy Ray Brown. The Fred Hutch-led team uses this breakthrough as a possible blueprint for new curative therapies that could reach patients worldwide.

Hutch researchers are conducting clinical trials exploring gene-modified stem-cell transplantation as an option as a cure for people who have cancer and who are HIV positive. These clinical trials combine low-dose chemotherapy with or without radiation.

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